Provider Demographics
NPI:1124535257
Name:ABANTAO, ERLINDA
Entity Type:Individual
Prefix:
First Name:ERLINDA
Middle Name:
Last Name:ABANTAO
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 3046
Mailing Address - Street 2:
Mailing Address - City:MALVERN
Mailing Address - State:PA
Mailing Address - Zip Code:19355-0746
Mailing Address - Country:US
Mailing Address - Phone:956-631-0393
Mailing Address - Fax:956-682-4689
Practice Address - Street 1:1801 S 5TH ST STE 215
Practice Address - Street 2:
Practice Address - City:MCALLEN
Practice Address - State:TX
Practice Address - Zip Code:78503-2932
Practice Address - Country:US
Practice Address - Phone:956-630-7788
Practice Address - Fax:956-229-6180
Is Sole Proprietor?:No
Enumeration Date:2018-01-10
Last Update Date:2020-10-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXAP134990363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily